Provider Demographics
NPI:1790893550
Name:FLEMING, ALFRED D (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:D
Last Name:FLEMING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 PIERCE ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-3796
Mailing Address - Country:US
Mailing Address - Phone:712-279-3383
Mailing Address - Fax:712-279-3384
Practice Address - Street 1:2730 PIERCE ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3796
Practice Address - Country:US
Practice Address - Phone:712-279-3383
Practice Address - Fax:712-279-3384
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-30379207VM0101X
NE17601207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IANA2137001Medicare PIN
IA41982Medicare PIN
NEE59947Medicare UPIN
NE160036114Medicare PIN
NENA2137Medicare PIN
NE098355Medicare PIN